Solna [Sweden]February 8 (ANI): WHO found that cervical cancer is the fourth most common form of cancer among women globally, with an estimated 604,000 new cases and 342,000 deaths by 2020. Treatment of severe prodromal cervical cancer, CIN3, can cause problems during later pregnancy among women in childbirth age.
A new registry study showed a higher risk of several unfavorable pregnancy outcomes after such treatment, but the risks have decreased over time and the increased risk of infant death no longer exists.
The study, from Karolinska Institutet, which covered a large number of births in Sweden over a 46-year period, was published in ‘The Annals of Internal Medicine’.
There has been a known correlation between treatment of severe prodromal cervical cancer (CIN3, or cervical intraepithelial neoplasia grade 3, high-grade dysplasia) and higher risk pregnancies later in life, including premature and very premature birth, neonatal sepsis and premature infant death.
In Sweden, between 10,000 and 20,000 women are treated for cell abnormalities as a prophylactic remedy for cervical cancer. Interventions against CIN3 have advanced over the years and are much less invasive now than they were ten years ago. However, the degree of effect that this medical development has had on the risk of perinatal complications has not been determined.
Researchers at Karolinska Institutet, Zhejiang University, China and the University of Gothenburg conducted a comprehensive registry study to compare pregnancies for women treated for CIN3 with women without such a medical history.
The registry study included a total of 4.6 million births between 1973 and 2018. The researchers studied the birth results for 78,450 women diagnosed with CIN3 and compared them with 784,500 women without CIN3. The two groups were comparable in terms of most variables, such as age, educational background and BMI. They also compared the results for a group of women (23,199) with a CIN3 diagnosis and their sisters (28,135) without a diagnosis.
The study took its data from the Medical Birth Register (MFR) and the National Board of Health and Welfare’s cancer register and Statistics Sweden’s multigenerational register, education register and the Swedish population register.
Their results showed that treatment of high-grade dysplasia involves a higher risk of premature and very premature birth, intrauterine infection, neonatal sepsis and premature infant death. According to the researchers, this suggested that pregnancies after treatment with CIN3 should be treated as high-risk pregnancies to reduce the risk of adverse outcomes.
“The good news is that all of these risks diminished dramatically over time to completely disappear prematurely before the end of the follow-up period,” said the study’s first author, Wei He, an associate researcher at the Department of Medical Epidemiology and Biostatistics, Karolinska Institutet. “A possible explanation for this is less invasive treatment methods for prodromal cervical cancer. This is important information for doctors and women in Sweden and the rest of the world.” In countries with population-based screening programs and follow-up cellular analyzes, an estimated six cases of dysplasia are treated to prevent one case of cervical cancer.
“In order to achieve the optimal balance between obstetric safety and the risk of cancer, careful considerations should be made on a case-by-case basis,” says the study’s final author Kamila Czene, professor at the Department of Medical Epidemiology and Biostatistics, Karolinska Institutet. “This is one of the major challenges in the field, which requires skill not only in treatment but also in management and colposcopy to identify the right women to treat.” (ANI)